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Frailty in mid-life predicts outcome following trauma

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Abstract

Purpose

Midlife adults (50–64 y) are at risk for falls and subsequent injury; yet current guidance on fall screening only pertains to older adults (> 65 y). Herein, we evaluated whether frailty was predictive of readmission for falls in midlife trauma patients.

Study design

This was a retrospective cohort study of trauma midlife patients admitted for traumatic injuries from 2010 to 2015. Demographics, injury data, fall history, and post-index readmission for falls were collected from medical records. Frailty scores were calculated retrospectively using the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA-CFS). The association between frailty and outcomes was assessed. p < 0.05 was considered significant.

Results

A total of 326 midlife patients were included, 54% were considered fit, 33.7% pre-frail, and 12.3% frail. Compared to their fit and pre-frail counterparts, frail patients were more likely to be female (67.5% vs. 46.3% vs. 36.3%, p < 0.001), have a history of fall (22.5% vs. 15.5% vs. 6.2%, p < 0.001), and to have suffered a ground level fall on index admission (52.5% vs. 20% vs. 5.7%, p < 0.001). Controlling for age, BMI, gender, race, and fall history, frailty was associated with readmission of midlife adults for falls (OR = 1.82 [1.23–2.69]; p = 0.003) and discharge to skilled nursing facilities (OR = 26.86 [8.03–89.81], p < 0.001).

Conclusions

Pre-injury frailty may be an effective tool to predict risk of readmission for fall and discharge disposition in midlife trauma patients.

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Acknowledgements

We thank Michele Lilienthal for her help in retrieving data from our institution’s trauma registry.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Division of Acute Care Surgery, Department of Surgery, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA

    Isaac C. Slagel, Dionne A. Skeete & Colette Galet

  2. Division of Vascular Surgery, Department of Surgery, University of Iowa, Iowa City, IA, USA

    Victor Hatcher

  3. Division of Burn Surgery, Department of Surgery, University of California, Davis, Sacramento, CA, USA

    Kathleen S. Romanowski

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  1. Isaac C. Slagel
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Correspondence to Colette Galet.

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Slagel, I.C., Hatcher, V., Romanowski, K.S. et al. Frailty in mid-life predicts outcome following trauma. Eur J Trauma Emerg Surg 49, 1071–1078 (2023). https://doi.org/10.1007/s00068-022-02145-0

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  • DOI: https://doi.org/10.1007/s00068-022-02145-0

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